Dominguez & Rucker Family Dentistry LLC

Primary specialty

DentistTaxonomy code 122300000X

License

SC3850 Issued in SC

Legal business name

DOMINGUEZ & RUCKER FAMILY DENTISTRY LLC

Practice address

575 Springcrest Drive
Suite a
Fort Mill, SC 29715-7307

Phone

(803) 547-1888

Fax

(803) 547-8533

NPI assigned

May 16, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Lori C Dominguez, DDSNPI 1558341479

Title

Owner Dentist

Phone

(803) 547-1888

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lori Christina Dominguez, DDS

  • Dentist
  • Fort Mill, SC
  • NPI 1558341479
  NPD Authorized official
• Carlton D Rucker, DDS

  • Dentist
  • Fort Mill, SC
  • NPI 1841248382
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485129600000",
    "number": "1508023649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 SPRINGCREST DRIVE",
            "address_2": "SUITE A",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157307",
            "telephone_number": "803-547-1888",
            "fax_number": "803-547-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 SPRINGCREST DRIVE",
            "address_2": "SUITE A",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157307",
            "telephone_number": "803-547-1888",
            "fax_number": "803-547-8533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINGUEZ & RUCKER FAMILY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2017-01-23",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "803-547-1888",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "SC3850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3850",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kim Dixon, RN
• Ivana Djordjevic Brooks
• DME of the Carolinas LLC
• Alexandra Liner Dock
• Amary Smith Doehling, FNP-C
• Lori Christina Dominguez, DDS
• Damien Donovan, DAC
• Heather Doran, MS, CCC-SLP
• Brittany Nicole Dossie
• Grenda S Dountz, R.N.

• Dentist in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.